Tympano-ossicular allografts for cholesteatoma in children.
At the Sint Augustinus Hospital, Antwerp, Belgium, all children with cholesteatoma are operated by a canal wall up approach and immediate reconstruction with a tympano-ossicular allograft. In the majority of the cases, a second stage is performed after 1 year. This paper presents the results of a retrospective review of the charts of 103 consecutive children treated between 1979 and 1995. The mean patient age was 10 years and the mean postoperative follow-up was 4.5 years. In 28 children residual cholesteatoma was found at the second stage operation and 20 developed recurrent cholesteatoma in the course of time. So far no residual cholesteatoma surfaced after the staged procedure, but 11 children needed more than two operations to control recurrent disease. An intact, trouble-free graft was present in 79 children at the latest follow-up. The median postoperative bone-conduction thresholds were equal to the preoperative thresholds. The median postoperative air-conduction thresholds improved in 50% of the cases, remained unchanged in 25%, and deteriorated in 25% of the cases. It is concluded that the tympano-ossicular allograft technique is effective and safe and offers good anatomical and acceptable functional results.
Schilder
A G
AG
University Department of Otolaryngology-Head and Neck Surgery, Sint Augustinus Hospital, University of Antwerp, Antwerp-Wilrijk, Belgium.
Govaerts
P J
PJ
Somers
T
T
Offeciers
F E
FE
D000293:Adolescent; D000704:Analysis of Variance; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000502:physiology; D001844:Bone Conduction / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000473:pathology / Q000601:surgery*; D004429:Ear Ossicles / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006309:Hearing / Q000502:physiology; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012449:Safety; D014184:Transplantation, Homologous; D014432:Tympanic Membrane / Q000637:transplantation*